Imaging CT feature for hepatic hemangioma?

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Imaging CT feature for hepatic hemangioma?

Hepatic hemangiomas have a distinctive enhancement pattern on contrast-enhanced CT. They are usually hypodense on noncontrast scans, then in the arterial phase show peripheral nodular, discontinuous enhancement. As you move to the venous and delayed phases, the contrast fills in toward the center (centripetal fill-in), so the lesion gradually becomes more like the surrounding liver. This progressive inward filling is the hallmark feature and helps differentiate hemangiomas from malignant lesions, which typically show early arterial enhancement with washout rather than this gradual centripetal fill-in. Options suggesting no enhancement or calcifications with ring enhancement don’t fit the classic CT appearance of a hepatic hemangioma, and early washout points away from a benign hemangioma toward malignancy.

Hepatic hemangiomas have a distinctive enhancement pattern on contrast-enhanced CT. They are usually hypodense on noncontrast scans, then in the arterial phase show peripheral nodular, discontinuous enhancement. As you move to the venous and delayed phases, the contrast fills in toward the center (centripetal fill-in), so the lesion gradually becomes more like the surrounding liver. This progressive inward filling is the hallmark feature and helps differentiate hemangiomas from malignant lesions, which typically show early arterial enhancement with washout rather than this gradual centripetal fill-in. Options suggesting no enhancement or calcifications with ring enhancement don’t fit the classic CT appearance of a hepatic hemangioma, and early washout points away from a benign hemangioma toward malignancy.

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